Antiphospholipid Syndrome

Question 1

What is antiphospholipid syndrome?

Answer 1

Disorder associated with antiphospholipid antibodies where the blood becomes prone to clotting (hyper-coagulable).

Question 2

What are the main complications in antiphospholipid syndrome?

Answer 2

Thrombosis and complications in pregnancy, particularly recurrent miscarriage.

Question 3

If it has not occurred independently, what my antiphospholipid syndrome be secondary to?

Answer 3

An autoimmune condition (e.g. SLE)

Question 4

What are the antiphospholipid antibodies that interfere with coagulation?

Answer 4

1. Lupus anticoagulant
2. Anticardiolipin antibodies
3. Anti-beta-2 glycoprotein I antibodies

Question 5

What is the name of the purple lace-like rash that occurs with antiphospholipid syndrome?

Answer 5

Livedo reticularis

Question 6

What is Libmann-Sacks endocarditis, which valve is most commonly affected, and which condition is it most associated with?

Answer 6

1. Non-bacterial vegetations growing on heart valve
2. Mitral valve
3. Antiphospholipid syndrome

Question 7

How is antiphospholipid syndrome diagnosed?

Answer 7

1. History of thrombosis or pregnancy complications.

2. Persistently raised antibodies.

Question 8

What is the pharmaceutical management of antiphospholipid syndrome and how does it differ in pregnancy?

Answer 8

1. Long-term warfarin (aim for INR 2-3 and 3-4 in recurrent thrombosis).
2. LMWH in pregnancy plus aspirin due to warfarin being contraindicated in pregnancy.